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May 17, 2000

Health Outcomes Among Patients Treated by Nurse Practitioners or Physicians

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;283(19):2521-2524. doi:10.1001/jama.283.19.2521

To the Editor: Several methodological flaws limit the conclusions of Dr Mundinger and colleagues.1 First, patients were randomized but not analyzed according to an intention-to-treat analysis. Seventy-nine percent of patients enrolled in the study completed the 6-month follow-up interview but only 66% of patients randomized in the study were actually enrolled. Thus, only 52% of randomized patients completed the study through the 6-month follow-up interview. Physiological and follow-up data on satisfaction and self-reported health status were derived from this 6-month follow-up interview. Drawing conclusions from such a low proportion of randomized patients may introduce confounding, which might have been avoided by assessing health status at the time of randomization.

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